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Title V Technical Assistance Meeting

 Working with State Legislators to Advance MCH Priorities

Tips for Title V Professionals



Emily Eckert
Program Analyst, Health Systems Transformation; AMCHP

Tahra Johnson, MPH
Senior Policy Specialist, National Conference of State Legislatures

Title V leaders are well-positioned to educate state policymakers on the unique needs of women, children and families. This insight can be particularly valuable when legislatures review bills related to important issues such as expanding continuity of coverage and care for children and families, improving systems of care for children and youth with special health care needs, and implementing Bright Futures guidelines for all children.

Building knowledge about the state legislative process and learning effective ways to communicate with legislators can help Title V professionals become go-to resources on MCH issues for legislators and their staff. How to do that was the focus of our workshop at the Annual Conference.

Understanding State Legislators

State legislators vote on legislation that affects maternal and child health (MCH) populations every year, including developing, overseeing and funding a wide range of programs. Although balancing the state budget and addressing other high-profile issues may take precedence, lawmakers continue to act on a range of issues related to MCH. Because of the variety and complexity of the policy issues before them, state legislators often rely on their staff, researchers, experts in the field, lobbyists, practitioners and community members to gather information and develop policies that address a need or respond to funding opportunities.

The nation's 7,383 state legislators are elected to represent the constituents in their districts. Legislators are policy generalists, not experts on most issues, although they typically have expertise in one or more policy areas. Regardless, they vote on issues from A to Z — agriculture to zoning — and may benefit from Title V's first-hand experience of working with MCH populations. Certain legislators hold positions of authority within the legislature, including the speaker of the House and the president of the Senate (who is sometimes the lieutenant governor), the majority and minority floor leaders and whips, and committee and caucus chairs. About 20 percent of legislators are new after each election, so it may be a challenge for them to learn about wide-ranging policy issues, including those impacting MCH populations.

This need for education presents opportunities for state agencies, like Title V, to share information on a wide range of policy topics.

Understanding Legislative Staff

Legislative staff members play important roles in the legislative process. Many legislatures, for example, employ a permanent, nonpartisan staff to provide research on specific legislation that may be considered during the legislative session. Some states have a separate research staff for each chamber, while others employ a single research staff that provides services for both chambers. In addition, legislatures employ other staff members, including legal staff, librarians, and fiscal and personal staff, among others. Your state legislature's website typically provides links to bills and laws, the state constitution, legislators' home pages, press releases, daily events, term limits, state agencies and more. (Note: The National Conference of State Legislatures maintains a clearinghouse of state legislature websites with links to every state legislature.) The role of state Title V programs in working with the legislature can vary from state to state. To find out what you can do in your state, seek information from your department's legislative liaison or your governor's office.

Questions to ask as you learn about your state legislature:

  • Who are the legislative leaders in my state? What committees are most relevant for MCH?
  • What agencies and staff serve the legislature in my state?
  • What is the party makeup of my legislature?
  • What is the legislative calendar in my state? What is the deadline for filing a bill?
  • What is the process for public input during committee hearings?
  • How can I find out the status of a bill or the committee to which it has been assigned?

Advice for MCH staff:

  • Become your state legislators' trusted source for MCH information. Keep your information succinct. Bulleted, one-page fact sheets are ideal. 
  • Be honest about the pros and cons of MCH policies, and be responsive, Legislators often need concise information fast.
  • Take advantaged of legislative downtime. An ideal time to meet with legislators is when they are not in session, because they have more time for learning and connecting.
  • Learn your state's budgeting process and how it involves the governor, the legislature and state agencies.

Frame your message.

  • How does the issue affect children and families in the state: Specifically, what are the costs and benefits related to a specific program or bill? What is the return on investment?
  • What are best practices? Has a program or strategy been implemented elsewhere with positive results? Could it be replicated here?
  • What are the consequences of not acting? For example, would it cost the state millions of dollars if it does not adopt teen pregnancy prevention measures in high-risk communities?
  • Would new efficiencies make programs more effective or less costly? 

For more information on working with state legislators, visit the NCSL website.